Director, Pharmacy Revenue Cycle Management

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The Director, Revenue Cycle Management for Humana Pharmacy will own the billing, collections and reporting for Center Well Pharmacy & Specialty pharmacy and Humana Pharmacy Solutions, Humana’s captive PBM.

This role will lead a large workforce across multiple geographies to maximize our billing while also ensuring to meet our patient, pharmaceutical clients and PBM partner needs.

Within Center Well Pharmacy, we continue to lead the industry with new product launches, including our Direct to Consumer and Direct to Employer offerings. This leader will be nimble and change oriented to meet the evolving market needs. This position may involve some financial budgeting as well as making decisions related to implementation of new/updated programs or large-scale projects to help support the strategic goals of the pharmacies.

Additionally, the candidate will have the following key responsibilities:

• Own the reconciliation of billing with the GL with partnership with controllership team
• Provide comprehensive decision-making across the enterprise as it comes to revenue accounting
• Develop and maintain team performance across our BPO partner and internal associates
• Monitor performance by comparing and analyzing actual results with plans and forecasts
• Improve financial status by analyzing results and variances, identifying trends, and recommending actions

• Bachelor's degree in finance, accounting or related field
• 8 or more years of revenue cycle management
• 5 or more years of management experience
• Experience advising senior leadership on billing/collections strategies
• Knowledge of pharmacy revenue cycle management
• Prior experience developing methods and criteria for revenue cycle management
• Exceptional communication and presentation skills, with the ability to influence and engage diverse audiences
• Ability to lead and manage special projects that may necessitate cross-functional partnerships
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

• Prior health insurance industry experience working in revenue cycle management
• Pharmacy pricing knowledge or experience

As part of our hiring process for this opportunity, we will be using an interviewing technology called Hire Vue to enhance our hiring and decision-making ability. Hire Vue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$126,300 - $173,700 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support…